Effectiveness of a multidisciplinary treatment program for chronic daily headache.

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Chronic daily headache (CDH: headache on fifteen days a month or more) is one of the most common forms of chronic pain. The relative efficacy of different treatment methods for these patients needs to be determined. To compare treatment outcomes for patients with CDH treated in a traditional office-based pharmacological treatment program with a second group treated in a multidisciplinary management program. Patient outcomes were measured using changes in the Headache Disability Inventory (HDI) and the Short-Form-36 (SF-36) over the treatment period. Outcomes from seventy patients treated in an office setting were compared to thirty-seven patients treated in a multidisciplinary headache treatment program. Both groups received similar pharmacological treatment. All patients treated in the office setting and the majority of patients in the multidisciplinary program had transformed migraine. Even though a reduction in headache days per month occurred, mean headache related disability (measured by HDI) and mean Health Related Quality of Life (HRQoL measured by SF-36) did not improve for the patient group treated in the office setting but did improve significantly for the patient group treated in the multidisciplinary headache program. For patients with CDH, headache-related disability and HRQoL is more likely to improve with management in a multidisciplinary headache treatment program as compared to the traditional specialist consultation-family physician office-based setting.